Several studies have documented the persistent under-use of influenza vaccination among elderly African American and Hispanic populations. However, little is known about the causes of this under-use, and consequently, it is unclear whether clinic-based strategies to improve vaccination rates will be effective in African American and Hispanic communities. The purpose of this pilot study is to provide preliminary data for an investigation into the causes of racial differences in influenza vaccination rates in the elderly. We propose to: 1. Assess perceived barriers to influenza vaccination use by holding focus groups with African American and Hispanic elderly patients, 2. Develop and pilot a survey based on information gained in these focus groups, and 3. Conduct a brief chart review to assess racial discrimination in the offering of influenza vaccination by physicians. The setting for this study is the Geriatrics Clinic at Mount Sinai Medical Center, which serves an ethnically diverse panel of elderly patients. The results of this analysis will be used as preliminary data for a more comprehensive study of the causes of racial disparities in influenza vaccination use, and of effective strategies to improve vaccination rates in African American and Hispanic communities.